Insurance firm to pay Rs 51,000 fine for denying claim to Hyderabad man

In a fall at his residence in Sanathnagar in the city in August 2015, Abdul Azeez had sustained head injuries.

HYDERABAD:In a fall at his residence in Sanathnagar in the city in August 2015, Abdul Azeez had sustained head injuries. He rushed to a private hospital where he was treated. He was charged `50,000 for the treatment but was denied cashless hospitalisation. This sent his diabetes and hypertension levels, which were already a cause of concern, soaring.

Aziz chose a policy of National Insurance Company which offered cashless hospitalisation facility but the reason cited by the insurance firm for denying him the facility was that he had been hypertensive and that medical condition was not covered under cashless hospitalisation policy. His several visits to the company’s office were fruitless and his rightful insurance claim was not accepted. Left with no option, he petitioned the Hyderabad District Consumer Disputes Redressal Forum 3.

After a two-year battle at the forum against the insurance company, Aziz was a relieved man with the forum directing the insurance company recently to reimburse the medical expenses to the tune of `50,000 and also to pay Aziz `49,000 in compensation and `2,000 towards court charges. The forum held the insurance company guilty of deficiency in service. “It is normal for every person of that age to have diabetes and hypertension, and there is every right for a policy-holder to reimbursement,” the forum remarked.

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